Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1400
10
1
gregorian
2022
1
1
36
1
online
1
fulltext
en
Prediction of Intraperitoneal Adhesions in Repeated Cesarean Section Using Sliding Sign, Striae Gravidarum, and Cesarean Scar
Gynecology & Obstetrics
Gynecology & Obstetrics
Original Research: Clinical Science
Original Research: Clinical Science
<strong>Background: </strong>Intraabdominal adhesions are associated with an increase in complications during cesarean section because of recurrent cesarean sections. This is why the possibility of predicting adhesions is important. In this study, the diagnostic value of depressed scar, severe striae gravidarum, and negative sliding sign, and their combinations were evaluated for predicting intraabdominal adhesions of cesarean candidates.<br>
<strong>Methods:</strong> This prospective descriptive study was performed during 2019-2020 on 123 pregnant women referred to Ayatollah Taleghani university hospital with a gestational age of ≥36 weeks 0 days who were candidates for cesarean section because of a previous cesarean section. In each patient, the presence of a depressed scar, a severe striae gravidarum, the absence of a sliding sign, and the presence and severity of adhesions during the operation were examined. Sensitivity and specificity, and positive and negative predictive values of each of the 3 indicators and their combinations were calculated.<br>
<strong>Results: </strong>The frequency distribution of severe adhesion in these individuals was 16.27%. The highest sensitivity was related to depressed scar and negative sliding sign (65%). The highest specificity was related to the negative sliding sign and its combinations (97%-99%). The highest positive predictive value was related to negative sign sliding and its combinations (81%-92%). The negative predictive values of depressed scar, negative sliding sign, and severe striae gravidarum, and even their combinations were almost the same and approximately between 89% and 93%.<br>
<strong>Conclusion:</strong> To predict the presence of adhesions in a cesarean candidate because of a previous cesarean section, you should first examine the striae gravidarum and scar. In the absence of a depressed scar and severe striae gravidarum, there is a 90% chance of no adhesions. According to this study, if both signs are present, it is recommended to check the sliding sign to obtain a more accurate estimate.
Cesarean Section, Intraperitoneal Adhesions, Prediction, Sliding Sign, Striae Gravidarum, Cesarean Scar
323
327
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6973-1&slc_lang=en&sid=1
Mojgan
Mokhtari
mmokhtari1345@hotmail.com
200319475328460069279
200319475328460069279
No
Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Minoo
Yaghmaei
yaghmaeim@yahoo.com
200319475328460069280
200319475328460069280
No
Preventative Gynecology Research Center (PGRC), Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Neda
Akbari Jami
dr.jami.neda@gmail.com
200319475328460069281
200319475328460069281
No
3. Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Masoud
Roudbari
roudbarim@iums.ac.ir
200319475328460069282
200319475328460069282
No
Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Dina
Jalalvand
Dinajalalvand@sbmu.ac.ir
200319475328460069283
200319475328460069283
Yes
Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran